-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Ed2cQ68NyvtU55jJjiB+G1PRAztIFyG5ocsX9iX0r6cy9h50585HOvzKkYAWtpbu hpxhd5YgL9CC4dZZXIDweA== 0001209191-09-030015.txt : 20090602 0001209191-09-030015.hdr.sgml : 20090602 20090602094142 ACCESSION NUMBER: 0001209191-09-030015 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090429 FILED AS OF DATE: 20090602 DATE AS OF CHANGE: 20090602 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BANCINSURANCE CORP CENTRAL INDEX KEY: 0000276400 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 310790882 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 7TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 BUSINESS PHONE: 614-220-5200 MAIL ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 7TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SOKOL JOHN S CENTRAL INDEX KEY: 0000949067 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08738 FILM NUMBER: 09866927 MAIL ADDRESS: STREET 1: 20 EAST BROAD STREET 4TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2009-04-29 0 0000276400 BANCINSURANCE CORP BCIS 0000949067 SOKOL JOHN S 250 E. BROAD ST. 7TH FLOOR COLUMBUS OH 43215 1 1 1 0 Chairman, CEO and President Common Shares 2009-04-29 5 G 0 E 3000 0.00 A 56197 I Custodian for minor children These 56,197 BCIS common shares are beneficially owned by John S. Sokol, as custodian for his minor children. John S. Sokol also directly beneficially owns 246,694 BCIS common shares. John S. Sokol may also be deemed to indirectly own 1,750,000 BCIS common shares which are owned by Falcon Equity Partners, L.P. ("Falcon L.P."), an Ohio limited partnership whose partners are members of the Si Sokol family and trusts for the benefit of members of the Si Sokol family. John S. Sokol holds, directly and indirectly as trustee of trusts for the benefit of members of the Si Sokol family, a 44.4% interest in Falcon L.P., and disclaims beneficial ownership of BCIS common shares held by Falcon L.P., except to the extent of his pecuniary interest therein. John S. Sokol's wife, Elizabeth M. Sokol, also owns 2,100 BCIS common shares. John S. Sokol disclaims beneficial ownership of such BCIS common shares, and the filing of this report is not an admission that John S. Sokol is the beneficial owner of such BCIS common shares for the purpose of Section 16 or any other purpose. /s/ John S. Sokol 2009-06-02 -----END PRIVACY-ENHANCED MESSAGE-----